The Mad Hatter doesn't suffer from insanity, they enjoy every minute of it. If only the Reluctant Psycho was so well-off. They may or may not understand the details, but they are well aware that something is wrong with their own psychology and they are fighting it to the best of their ability, possibly with the help of medication. Success will vary; perhaps they do manage to present a normal façade, but they are fighting a constant inner battle to maintain it. Or maybe they have found an outlet to channel their issues productively, or, in the most tragic cases, they are constantly fighting a losing battle and may only realise they have given in again once it is too late. Whatever the details, they both know that they are mentally unwell, and desire to cancel or curtail the effects of their illness.
If they are fortunate, they may have the support of a Friend to Psychos. If they are terribly unfortunate, the plot will conspire to make their already-difficult struggle even harder for them; it may even become necessary for them to give in to get out.
This is a very particular subtrope of the Tragic Flaw; examples that are about temptations and tendencies that are not actually insanity go there.
Truth in Television for many people with mental illnesses, by the way. However, despite the scary-sounding trope name, most Real Life people in this situation would not be dangerous to anyone, except maybe themselves, if they lost control of their illness. Being Ax-Crazy is a lot more common in fiction than reality, after all, despite the occasional Real Life urge. There is also the fact that if you are aware enough to be ashamed of it, you are probably doing something (such as psychotherapy or medication) to mediate the symptoms.
Contrast The Mad Hatter, which is about the cartoonish kind of insanity, Gollum Made Me Do It, which is a similar trope in which an evil Split Personality is the specific form of insanity in question, and Fighting from the Inside, in which they are not only trying to keep control but to take it back from someone else.
- Monster: Johan Liebert who, despite being committed to carrying out evil acts and appearing to enjoy every moment of his wicked trajectory, seems to find his evil hopelessly banal on some level, to the point that when he re-reads a children's book that disturbingly reminds him of his past, his goals began to markedly shift from world annihilation to self-annihilation. Not that he isn't still an Omnicidal Maniac caught in a hungry ghost cycle, though...
- Soul Eater: Dr. Franken Stein is an unhinged genius with a violent edge to him that loves dissection and even enjoys his own craziness. However, he doesn't want to let it get too far or let himself get too bad, so he basically worships the Shinigami for giving him stability and purpose.
- Sakamoto Days: Apart is a Serial Killer who cuts people to pieces because he's so insecure about being "normal", he needs to reaffirm how he and others are all the same "on the inside".
- Ken Hidaka in later parts of Weiß Kreuz. Once he realizes that he has started to enjoy killing people, he tries to ride it out, but it just gets worse. He ends up going to prison voluntarily, to have "time to think," until he can get his head on straight and go back to killing people responsibly.
- Zanuff The Butcher is a Serial Killer who is painfully aware that he's a monster but is unable to stop his murderous impulse from surging forth. The best he can do is to struggle and curb it on a daily basis. The main conflict of the story is his bonding with a little girl, Alice, while desperately trying to fight off his urge to make her his next victim.
- In Batman: Gotham Adventures #11, The Riddler tries to circumvent his obsession with leaving clues that lead Batman right to him by instead leaving clues that lead to other criminals. This works out fine until Batman pieces together hidden riddles in each of the clues that lead him to the Riddler anyway. When the Riddler realizes that he has done this, he is heartbroken.
Riddler: You don't understand. .. I really didn't want to leave you any clues. I really planned never to go back to Arkham Asylum. But I left you a clue anyway. So I... I have to go back there. Because I might need help. I... I might actually be crazy.
- Batman himself, and other members of the Bat-family, are sometimes implied to worry about their own mental health. In an issue of Robin, the titular boy wonder says that he is afraid that Batman might be going crazy. His girlfriend, also a masked vigilante, just laughs and says, "Well, look at us."
- Harvey Dent is one of the only inmates in Arkham who is actually trying to rehabilitate himself, rather than treating Arkham as a second home. Unfortunately, Two-Face is not open to rehabilitation since he knows it will "kill" him. Harvey's efforts always end in failure and tears.
- Likewise, the common modern portrayal of the Mad Hatter is as a legitimately insane man who really doesn't want to kidnap, entrance or murder, but who is assaulted by irresistible compulsions and delusions that break his sense of reality and always ultimately control him no matter how hard he fights.
- The Joker revels in his madness most of the time, but since one symptom of his insanity is his shifting characterization, this isn't always the case. At the end of The Killing Joke, he almost considers Batman's offer to rehabilitate him before regretfully saying that it is too late for him to try. In Emperor Joker, he decides to use his new cosmic powers to destroy the universe, because any universe that would allow someone like him to exist must be fundamentally broken.
- Captain America: Jack Monroe, the man who became The '50s Bucky, started to go insane during the last year of his life, as the supersoldier serum in him started to deteriorate. He was well aware that his mind was falling apart, and considered his last bouts as a superhero his way of staying sane. With the twist that they were not, because he had already become delusional. He was beating up random civilians, thinking that they were gangsters and drug dealers.
- The Boys: The Homelander, to paraphrase Billy, became a psychopath by accident. He's repeatedly seen committing disgusting atrocities (like eating babies) and others happen offscreen (like raping Billy's wife), and visual evidence of his indulging himself as well. Many of them are actually committed by his clone, including the rape, who deliberately records himself and sends the pictures to the Homelander to gaslight him into thinking he really is insane and can't remember it. This leads the Homalander to embrace evil and outright rebellion, giving Vought-American no choice but to unleash their contingency plan in case he got out of control: Black Noir. How do they know he can do it? Because Black Noir is Homelander's clone, and in fact set the whole thing up because his sole purpose in life was to take out the Homelander, which wasn't an option as long as he was content with low-level hedonism.
- Azula, fresh from freedom from the asylum in Avatar: The Last Airbender The Search is aware that she has lost control of her mind and she is not happy about it. Her goal is to silence the voice in her head that is causing her so much pain and doubt, but the only way she thinks that will happen is to kill her mother, which Zuko will not let happen for very obvious reasons.
- Superboy-Prime was like this at the beginning of Infinite Crisis, being horrified at how he inadvertently dismembered many of the superheroes trying to fight him, but after his time trapped in the Speedforce he fully crossed the moral event horizon.
- Abraxas (Hrodvitnon):
- Zig-Zagged by Sergeant Travis. He doesn't turn Ax-Crazy from extensive exposure to Ghidorah's severed head, but it becomes clear something's wrong inside his noggin, and he's torturously aware of it, pleading that he just wants to feel like himself again.
- According to Word of God, Ghidorah was once this in the beginning of its Backstory. Ghidorah's three brains had three words forcibly hardwired into them through indicated alien brain surgery, which consciously and unconsciously tormented the three heads ceaselessly and drove them to try again and again without success to make the ceaseless phrase stop by sating it. The author suggests these words probably faded to something like tinnitus later in Ghidorah's life, but by then, Ghidorah's Slowly Slipping Into Evil had come full circle.
Kill Them All.
- Featured as a running theme in Bird, and played for horror and tragedy from many angles. The stand-out example might be Mimi, whose power messes with her brain chemistry and causes sharp mood swings. Extremely dangerous for someone with Pyrokinesis.
- In Point of Succession, while talking with Beyond Birthday, Light seems to realize that there might be something fundamentally flawed with his own psychology:
- Light: You knew this was a temporary arrangement. It's not like we could talk forever.
Beyond: I think we could. And never get bored. You aren't a boring individual Sweetie Jam, despite what you try so hard to show the world. And me, I know I'm not boring.
Light: Don't be too sure hun, the killing people thing gets old real fast.
Beyond: How would you know?
Light: We all have fantasies. Some are just bloodier than others.
- In Ragnarok, Light's father Soichiro catches onto his son's growing mental problems early enough to retrain him out of his Black-and-White Insanity to follow A Lighter Shade of Gray. Light constantly struggles with thinking of the criminals he pursues as a detective as "Evil", and has to remind himself "Shades of gray, Light. The world exists in shades of gray."
- The protagonist of the Dragon Age fic Middle Of Nowhere posits insanity as a reason he's in Thedas. His method of dealing with the insanity is to accept it and just run with the situation while still acknowledging the crazy.
- In this My Little Pony: Friendship Is Magic fic, the EQG version of Cozy Glow is portrayed as this, believing Sunset to be a creation of her psychosis due to a half dose of her morning medicine. She later writes a letter to her pony self, advising similar treatment.
- 12 Monkeys: Cole's generally relatively calm, if confused, but he has some violent outbursts that suggest that he might be a prisoner for good reason.
- John Nash is in this position in A Beautiful Mind, once he figures out that he actually is schizophrenic. By the end of the film he's able to manage his condition with medication and by constantly checking to make sure other people can see new people he meets.
- Grosse Pointe Blank:
Dr. Oatman: You didn't tell me what you did for a living for four sessions. Then you told me. And I said, "I don't want to work with you anymore." And yet, you come back each week at the same time. That's a difficulty for me. On top of that, if you've committed a crime or you're thinking about committing a crime, I have to tell the authorities.
Martin: I know the law, okay? But I don't want to be withholding; I'm very serious about this process. [Beat] And I know where you live.
- In The Guilty, Iben unwittingly kills her infant son Oliver during a psychotic episode under the belief that she's letting snakes out of his abdomen. However, she displays no aggressive tendencies and is horrified when she realizes what she has done.
- In M, the eponymous murderer of children insists that he is this. He uses this to contrast himself against the mob after him. While he may be a child-murderer, he has no control over it and didn't choose it; the criminals who are after him though chose to be criminals.
Hans: But I, I can't help myself! I have no control over this! This evil thing inside me, the fire, the voices, the torment!... It's there all the time, driving me out to wander the streets, following me, silently, but I can feel it there. It's me, pursuing myself. I want to escape, to escape from myself. But it's impossible. I can't escape. I have to obey it. I have to run endless streets. I want to escape, to get away. And I'm pursued by ghosts. Ghosts of mothers. And of those children. They never leave me. They are there, always there. Always, except when I do it. When I... Then I can't remember anything.
- Francis Dollarhyde in Manhunter struggles with his murderous impulses, trying (and failing) to live an emotionally normally life through his brief relationship with Reba.
- The Man from Colorado: At least initially, Owen knows that what he is doing wrong but cannot stop himself. Following the massacre, he writes in his diary that he just killed 100 men and that he did not want to do it but could not stop himself.
- In the Psycho series, Norman Bates really doesn't enjoy being crazy and rightly considers it a mental sickness. He is terrified when he thinks he's relapsing in Psycho II since he's unaware that he's the target of a Gaslighting campaign.
- Eddie Miller in The Sniper knows that what he is doing is wrong but cannot stop himself. The night before he commits his first murder he deliberately burns his hand on a hotplate in an attempt to have himself committed to a psych ward. This almost succeeds, but a wave of patients from a major accident causes the doctor to forget about Eddie. After his murder, Eddie sends an anonymous note to the police begging them to catch him before he kills again.
- At one point in Targets, murderer-to-be Bobby Thompson fumblingly tries to alert his wife that something is going horribly wrong with his brain, but she brushes off the discussion and goes to sleep.
- In The Dead Center, this is what psychiatrist Dr. Forrester thinks is going on with the mysterious John Doe that's been brought into the psych ward. John Doe is being driven insane and taken over via Demonic Possession.
- Backstory for Thir13en Ghosts reveals this was the case for the Jackal. He was a serial killer and rapist who targeted stray women and prostitutes, but he was also aware that what he was doing was wrong. Eventually he committed himself to an asylum in hopes of correcting his insanity, but this proved impossible. When the asylum caught fire, the Jackal chose to remain in his cell and burn to death rather than return to his old ways.
- In Spider-Man: No Way Home, Norman Osborn was shown to have come to feel this way about his darker half, the Green Goblin. In his home universe, he was more open to the Goblin's influence, attributing many of the acts he had committed then to him. Here, however, he wants nothing to do with the Goblin, smashing his mask in an alleyway, and, upon being cured of him, all Osborn could do is sit and reflect with horror over what he had been forced to do by the Goblin.
- 2666: Amalfitano knows he's going crazy and occasionally mentions the possibility of being committed to an asylum.
- A Song of Ice and Fire: Serial pedophile-murderer Septon Utt is always remorseful after his crimes, though he's unable to stop himself from doing it again.
- John Wayne Cleaver in I Am Not a Serial Killer is not, but he is acutely aware of how likely he is to become one. He is not technically a sociopath, but only because until he turns 18 the relevant diagnosis is Conduct Disorder. He has a strict list of rules to adhere to keep himself functional, barely managing to pass himself off as normal most of the time... and then events conspire to give him every good reason to start breaking his rules to protect himself and his family.
- Deanna Madden, the title character of The Girl in 6E, wishes she did not have almost constant homicidal fantasies and ideation. But she does, and she has had enough close calls that she finally gave up and locked herself in apartment 6E, which she has not left in three years.
- Francis Dolarhyde in Red Dragon tries and fails to conquer his perverted and murderous impulses. In one scene, he even destroys (and eats) William Blake's Red Dragon and the Woman Clothed By the Sun painting with the hope that this will destroy the personification of his evil impulses.
- Zane, in the Mistborn trilogy, is fully aware that he is insane (he understands that hearing the voice of "God" which tells you to kill everyone you meet, obviously isn't normal), but he feels that it isn't an excuse for irrational behaviour and that it is merely a flaw he must overcome. In the end, it turns out that while Zane is an unstable psychopath, the voice he was hearing in his head was quite real- it was the series' Big Bad, and while it wasn't quite God, it was the next step down. So even though he was crazy, he wasn't as crazy as he thought he was, if that makes sense.
- In The Stormlight Archive:
- Nan Balat tortures insects and small animals to relax. He maintains the habit because he is afraid that if he stops, he will start torturing people instead of animals.
- Szeth is very well aware that sanity is slipping away from him, and doesn't like this one bit, but he feels like going with the flow is the only option left to him.
- Nale suffers from a particularly homicidal form of Black-and-White Insanity and usually just doesn't care, but when Lift manages to bring him to lucidity for a while, he sadly acknowledges that he's getting worse.
- Patrick Bateman in American Psycho fantasizes about killing people and often takes drugs to suppress his urges. However he gets worse, and finds himself killing people regularly just for the thrill of it. He mentions this to other people as a cry for help, but they don't even notice it. Because of this, it can be interpreted that nobody seems to mind (after all, Patrick is part of a rich social class who could buy themselves out of prison), that no one is actually listening to anything he says (the novel is a parody of the The '80s yuppie culture) or that he is deluded and he has either never killed anyone or mentioned it to anyone.
- Although Dickarus McChink, protagonist of Tales of the Space South, begins the story going on nightly rape/murder sprees, he is victim to the endogenous drugs that force him to go on psychotic rampages.
- Rachel from Animorphs. While she starts out as simply a bold, enthusiastic fighter, she slowly comes to realize that her enjoyment of combat and carnage is getting out of hand. It's made worse by the fact that her friends have come to rely on her to do the dirty work. In her final book before the finale, she admits that they need her to be the bad guy, and she needs them to be the good guys, because if they're not the good guys, and she's doing all this brutal killing, well...
- Worm has Regent, resident Token Evil Teammate of the Undersiders due to his high-functioning sociopathy...and doesn't actually like it all, since said sociopathy was a defense mechanism against Heartbreaker's Mind Rape Emotion Bomb powers. He really does want to experience unselfish love and a full emotional spectrum, but he himself admits he's so dead inside he can't even work up enough emotion to be truly upset by the way he acts.
- Dexter is an excellent example of the Reluctant Psycho who uses a productive or at least acceptable outlet to relieve his issues - through vigilante justice, in his case.
- Sherlock Holmes is typically perfectly willing to embrace his sociopathic tendencies, but occasionally shows hints of inner turmoil over whether they are actually more of a strength or a weakness. (John is helping him deal with the aspects that cause him problems; Mycroft is not nearly so conflicted.)
Sherlock: Look at them. They all care so much. Do you ever wonder if there's something wrong with us?
Mycroft: All lives end. All hearts are broken. Caring is not an advantage, Sherlock.
- In The Reichenbach Fall, he consciously becomes a full Reluctant Psycho after the police department's perception of him, heavy on the 'psycho' and light on the 'reluctant', goes wrong in the worst possible way.
- Firefly: River Tam initially appears to be simply insane, but as the series progresses it becomes clearer and clearer that she can understand what's happening and recognizes how very screwed up she's become. Joss Whedon pulls no punches in showing just how much this hurts her.
- In the Criminal Minds episode "Friends Like These," the unsub was said to be suffering from paranoid schizophrenia and insomnia. Once his medications stopped working his hallucinations taunted him into murder since the only way he could sleep was after the adrenaline rush from the kills. Throughout the episode he was begging "his friends" to just go away because he didn't want to kill and just wanted to sleep.
- In another episode, Reid meets a young man struggling with violent urges that he's so far managed to resist. At the end of the episode, he's alone in a room with a prostitute and a knife but instead of attacking her, he tries to kill himself.
- Lie to Me - there was an episode called "The Core Of It" where the main suspect/witness was a young woman suffering from Dissociative Personality Disorder. When they got around to talking to the original personality she was a wreck because she had no control over the other personalities - a law student and a prostitute. She is trying to fight it - just failing.
- Through the entire first season of Heroes this was the struggle for Nikki Sanders.
- A sort of odd example in Druitt from Sanctuary. He's an abnormal whose power is to teleport, but each time he teleports he becomes susceptible to an energy being who eventually takes up residence in him. This drives him to becoming Jack the Ripper, but once he's not a villain in the series he's struggling to make sure he doesn't go mad again and takes medication to make sure. It's not a possession - the presence of the being just makes him mentally unbalanced in the form of bloodlust and rage, not actually forces him to do anything.
- Hill Street Blues: One episode had a plotline about a murder at a homeless shelter, where the only witness was a man who turned out to have Multiple Personality Disorder... and eventually, he put the pieces together and realised that one of his personalities was the killer, and ended up taking a dive off an apartment building to make sure it could never happen again.
- Three Days Grace has the song Animal I Have Become, from the Reluctant Psycho's perspective.
- Similarly, Skillet's Monster.
- Dark Angel's "The Death of Innocence" is about a self-loathing pedophile who knows that he is a menace who destroys lives. He desperately begs for someone to kill him, before he re-offends.
- Dismember's song "Bleed For Me" describes a psycho putting someone through Cold-Blooded Torture. The very last lyric is a plea of "please make me stop".
- Members of the Wayward creed in Hunter: The Reckoning have a vision for the world's supernaturals: their complete destruction by any means necessary, no matter who gets in the Waywards' way. Whatever creates Waywards rewrites their minds, makes it so that they see planning and committing mass murder and destruction as the best way of dealing with supernaturals - but while most Waywards accept this, not all do. Some struggle with their newfound genocidal urges, try to restrain themselves for a while, lead normal lives, but the urges never go away, not permanently.
- American McGee's Alice, especially in Madness Returns when she's consciously aware that she's been in an insane asylum.
- Subject 16/Clay Kaczmarek from the Assassin's Creed series is fully aware of the fact that his psyche is irreparably shattered, but desperately fights through it to get his message across to Desmond.
- Batman: Arkham Series: The Mad Hatter. Ironic, since The Mad Hatter is characterized by enjoying his own madness. However, he doesn't respond poorly to being called mad.
Tetch: As a hat. Yes, as a hat.
- Muggy from Fallout: New Vegas is a miniature Securitron designed to be crazily obsessed with coffee mugs, all part of his creator Dr. 0's mocking jealousy towards robotics baron Mr. House. The worst part is that Muggy is aware of all this, and bitterly hates his creator for it even as he compulsively stockpiles coffee mugs.
Muggy: Of course I'm obsessed, they made me this way. You think I don't KNOW how crazy I sound!? Of course I do! THEY PROGRAMMED ME TO KNOW THAT TOO!
- God of War (PS4): After the events of God of War III, a Reformed, but Not Tamed Kratos prefers to give stern warnings to any threats to him and Atreus. He'll only be violent when he needs to protect his son or himself.
- Borderlands 2 has Krieg, one of the DLC player characters. His background is left intentionally vague, and the only real fleshing out he gets in a promotional video that shows how he met Maya, as he fights a losing battle with his own psyche to avoid killing an innocent person. While most of his spoken lines are incoherent word salads screamed at the top of his lungs, occasionally you can hear a much calmer voice that says things like "That's right, help 'em. Just like old times," when reviving a teammate in co-op.
- The "Fantastic Fustercluck" DLC of Borderlands 3 expands on this. Krieg's sane side and mad side are sick of each other, and Sane Krieg even hopes there's a way for him to escape to a separate body so he can finally know peace. However, events of the story show that even his mad side isn't actually evil, and cares about him, and the two halves eventually accept that they need each other.
- The player character of Cube Escape: Seasons is clearly aware that they're dangerously mentally ill. They take Prozac daily, went to Rusty Lake because it was advertised as a place for patients, and one of the notes they leave on their bulletin board is "I'm afraid I will do something terrible." Additionally, when it looks like they really did do something terrible (murdering a woman who turns out to be themselves - it's that kind of game), they seek to change the past to prevent this from happening. They also double as a Tragic Monster after you learn in The Mill how they came to be what they are.
- A serial killer that targets elves in Dragon Age II goes so far as to ask you to kill him to prevent him from killing again, as his father, a magistrate and the quest-giver for this particular mission, will just get his crimes swept under the rug.
- Hotline Miami and its sequel, Hotline Miami 2: Wrong Number, have Jacket and Richter, respectively.
- Although Jacket is extremely violent and brutal towards the enemies that he encounters, he does have several moments of apparent lucidity which clearly show that he doesn't enjoy committing these horrific acts as much as it seems. The most notable instance of this is at the end of the first mission, where he rips his mask off his face and pukes his guts out after murdering a random homeless man who caught him disposing of evidence.
- The second game shows that the only reason that Richter attacked The Mafiya and became a hitman for 50 Blessings was because the latter were using his sickly mother as a bargaining chip for his services.
- Kuon Ichinose, the creator of EMMA and Sophia in Persona 5 Strikers, is a near-Empty Shell, who refers to herself as an "emotionless doll", and almost completely lacks the ability to express emotions or genuinely connect to people. Reminding her of this or asking her about the human heart (which she claims she doesn't really have) is one of the only things that is guaranteed to get an emotional reaction - specifically, it makes her upset and angry she can't feel emotions normally.
- In Doki Doki Literature Club!, in the second act, Yuri starts acting increasingly disturbingly thanks to someone tampering with her mind from the outside, reacting to the Player Character with rather excessive excitement and feeling urges to do some things of a sort you wouldn't tell others about, except eventually she starts doing that too. She will repeatedly catch herself at it, however, and be as disturbed as anyone. This is especially painful next to her normal personality, which is reserved, intellectual, and trying hard to be dignified although often clumsy and anxious.
- Kirei Kotomine of Fate/stay night is an especially interesting example, in that he acknowledged intellectually that his particular brand of sociopathy (only taking joy in other people's suffering) was both harmful and immoral—without being told, and without anyone noticing. He then spent twenty years trying to correct himself, establishing himself as a heroic figure within his organization, without anyone ever suspecting his true nature. He only gave up trying after his wife, whom he had married as a last-ditch effort to teach himself to love others, committed suicide in front of him in order to prove that Kotomine COULD care about others. Unfortunately, Kotomine instead realized that his only emotion afterwards was regretting that he didn't kill her himself. His later philosophical defense of Angra Mainyu is simultaneously an overt attempt to justify his own existence. There is also his interest in Shirou Emiya, the adopted son of his enemy from the 4th Grail War, Kiritsugu Emiya. Shirou, unlike Kiritsugu (who was Kotomine's Foil in every respect), isn't so different from Kotomine.
- In Fate/Grand Order, the Saber version of Gilles de Rais does have Madness Enhancement EX, but is clearly using his emotional dependency on Jeanne d'Arc (and at higher bond levels, on the Master) to repress it. His Bond 5 line is to beg that you mercy-kill him with your Command Seals if he becomes what he's most famous for.
upon third Ascension: Jeanne, forgive me! I truly hate... everything! And everyone!
- Brynhildr from Fate/Prototype doesn't want to be a yandere, but she was cursed by Odin to easily fall in love, while also being cursed with the fate of always killing the target of her affection. The more she loves someone, the more her urge to kill them increases. In Grand Order, it's an outright game mechanic; there are Servants with the trait Brynhildr's Beloved, those with the qualifications to be Brynhildr's ideal lover, and they take extra damage from her Noble Phantasm, a spear that grows bigger and heavier against those she loves.
- In Fate/Grand Order, the Saber version of Gilles de Rais does have Madness Enhancement EX, but is clearly using his emotional dependency on Jeanne d'Arc (and at higher bond levels, on the Master) to repress it. His Bond 5 line is to beg that you mercy-kill him with your Command Seals if he becomes what he's most famous for.
- In V's route of Mystic Messenger, we see that before Rika truly spiraled into delusional disorder, she told V numerous times that she felt herself growing more and more mentally unstable; anxiety, paranoia, panic attacks, suicidal thoughts, and burgeoning psychosis plagued her every day, and she feared that she would soon completely lose touch with reality and become someone else. V decided that his quote unquote "love" was all she needed and insisted that her fear and self-loathing was beautiful, electing to not tell anyone in the RFA that she was suffering and instead chose to take pictures of her, brushing off her reluctance to go to therapy, and generally stand idly by while she fearfully slid into insanity. During Another Story when we get to actually interact with her personally, even while she's delusional and in the throes of her messiah complex, she acknowledges that she's unwell, and it makes the instances when she snaps out of it and realizes what's going on around her and what she's been doing even harder to watch. V eventually admits during his route that he never truly loved her at all and that her current mental state is his fault.
- Shiki of Tsukihime. The story starts with him expertly murdering a woman he happens to meet; overcome by guilt, he either goes into denial or attempts suicide. She doesn't stay dead, but Shiki's attempts to understand and control his problem in the face of supernatural evil make up a large part of the story.
- The Beast/The Swordsman/Yukimasa from The House in Fata Morgana is extremely violent and cruel but is brought back to sanity by The White Haired Girl and tries to restrain his violent urges while with her.
- A Miracle of Science — A known issue for those recovering from Science-Related Memetic Disorder.
Djaya Sumatera: When you're a recovering mad scientist, you're always afraid you'll lose control and wake up some morning with a half-built time machine in the living room and a plan to go back in time to pants Hitler.
- Jack Delitt from Newheimburg has a major problem controlling his paranoia.
- Vriska Serket, to oversimplify grossly, cycles between 'I know exactly what I'm doing, and anyone who 8urns themselves on all the irons I've got in the fire totally deserved it 8ecause I'm JUST TH8 AWESOME!!!!!!!!' and 'I'm a horri8le person, what the hell is wrong with me, why doesn't everyone h8 me????????' which then tends to lead back into the former by way of 'You SHOULD h8 me! I'll MAKE SURE that you h8 me!'. She starts out in a fairly low-key phase two, but the phases intensify and she spends increasingly more time in the first category as the series progresses since SGRUB is tailored to feeding her megalomania.
- Mituna Captor has significant brain damage, and tends to constantly alternate between screaming awful things at people and saying "1M 50RRY" immediately afterward.
- Belkar from The Order of the Stick doesn't seem like one of these for most of the story. But here, he freely admits that his kill-happy tendencies nearly screwed him over badly since he didn't have Roy to keep him on a leash at the time. His last line in this strip hints that he is starting to hate what he is. The line itself isn't that different from things he's said before, but previously he would look smugly satisfied about it. Belkar always realized he's a bad person, but this is the first time he seems to wish he wasn't.
Belkar: Isn't that why you losers keep me around? Hurting people is the only thing I'm good at.
- Calvin McMurray of Lackadaisy is normally quiet, shy, and subdued to the extreme, but when faced with the threat of or the opportunity for violence goes utterly Axe-Crazy and Laughing Mad. He was thrown out of the police academy for being too "enthusiastic" during firearms training, and is very depressed about failing to achieve his dream of becoming an officer... His cousin Rocky, wanting to help him recover and find work, drags him into being a bodyguard/enforcer for the Lackadaisy speakeasy and doesn't quite understand why Calvin gets so distraught after a job well done.
- Freefall: Dr Bowman is not best pleased that he was created to be a weapon, by people who left a lot of the nastiest instincts of a furious chimp in place, or even exaggerated them; he can't handle crowds (he barely has the energy to handle one person for more than a few minutes), he Hates Being Touched, he has anger issues that would make Norse berserkers take a breath and step back, he has serious trouble with concepts such as asking permission, he instinctively treats eye contact from a human as a threat, and so on. His entire life could be described as a sequence of attempts to 1) control his own issues, 2) develop ways to work around them, and 3) ensure that the next generation of artificial intelligences, both robotic and biological, do not have to deal with the same shit he did from their brains. As a result, he does things like issue other people with activators for his shock collar so that if he goes within five feet, he gets shocked into unconsciousness.
At some point, I'm going to throw the datapad. I don't have control over this. If my arm goes back, get out of the way.
- In Gifts of Wandering Ice, it takes a sociopathic personality type to control the psi-profiles (which were originally developed as Brain Uploading meets Grand Theft Me, and so carry all high-security passwords and such necessary to keep the place running). As such, the leadership of the tribes are all descended from specially engineered sociopathic soldiers, and given extensive therapy/training to develop their cognitive empathy to the point that they can be regular members of society despite lacking affective empathy.
- Julian in The Guide to a Healthy Relationship suffers from hallucinations and paranoia, among other things, but constantly keeps themselves in check, reminding themselves that nobody's pursuing them, that there are no bugs crawling under their skin, and snarking wryly at their hallucinations when they tell Julian that they're worthless and should just go kill themselves.
- The Nostalgia Critic. He regrets his psychotic episodes, doesn't want them to happen and tries to tell people that he's down to earth and logical instead.
- Inverted in his other character, Ask That Guy with the Glasses; he's creepy, undeniably psychotic, perverted, obsessed with human sacrifices (and onions)... Then in one episode his medicine wears off. Turns out in his lucid moments, he's actually completely aware that he's being drugged into being so awful, and now's his chance to escape and - nope, gets drugged again and it's business as usual.
- The AI protagonist of The Last Angel is a weird hybrid of this and The Mad Hatter. Nemesis is fully aware she isn't mentally stable, but she only cares because it interferes with her ability to perform her self-appointed mission: revenge on the alien empire that enslaved humanity despite her best efforts. She absolutely loves playing up her madness to terrorize her enemies and exploit their fear of AI.
- Adventure Time:
- Ice King (AKA Simon Petrikov) knows that something is wrong with him, but doesn't know what. His last video log before being driven completely insane has him hoping that one day he might find his way back to sanity. In later episodes, it is mentioned that he knew that he wanted to stop using the crown because he knew what it was doing to him, but he needed its power to be able to save Marceline.
- When Lemongrab's not busy being an ass, he is a very sad man who is confused as to why he doesn't understand people, and why other people don't understand him. He is a failed experiment and is all too aware of his abnormality.
- Implied with T.K.O. in OK K.O.! Let's Be Heroes during "TKO Rules!" when we see a Blink-and-You-Miss-It still featuring a drawing◊ by T.K.O. It's understandable considering he's the physical manifestation of K.O.'s rage and self-doubt, while K.O. himself is an extremely kindhearted individual who would despise doing anything T.K.O. does.
- Leatherhead in Teenage Mutant Ninja Turtles (2012) is a violent, bitter, antisocial mutant with a Hair-Trigger Temper, and he's fully aware of this and is NOT happy about it. This is primarily why he keeps his distance from anyone and everyone for their own safety. Because the Kraang experimented on him for so long he cannot keep his rage in check, especially if they're mentioned within earshot of him.
- Truth in Television. Charles Whitman, before barricading himself in a bell tower and killing 14 people, wrote a suicide note explaining that he knew something was very, very wrong with him and to use any money left over from his life insurance to pay for research to prevent it from happening again. (Turns out he had a brain tumor pressing on his amygdala, which was the size of a pecan and necrotic. That means he had a tumor that was rotting inside his own brain.)
- Serial killer Ted Bundy may have been one of these. According to his defense attorney John Henry Browne, who believed that Ted was absolutely born evil, one of the only times Ted ever showed what appeared to be genuine emotion instead of faking it, was when expressing a desire to be a good person. Bundy also likely went to Florida after he escaped from prison because he wanted to be able to get the death penalty, and he turned down a plea bargain that could have saved him.
- Various people who've interviewed cannibalistic serial killer Jeffery Dahmer have noted he was perfectly aware of his various problematic urges (necrophilia, and homicidal fantasies, to name a few), and absolutely hated them. He developed alcoholism as early as sixteen to try and control them, and was noticeably upset and sobbing on many of the tapes that exist of him being interviewed after his capture.